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Friday, September 26, 2008

Visual Scenes - What Do They Mean to Our Students

The big trend right now in AAC is visual scene displays (VSDs). All of the major AAC manufacturers (Dynavox on InterAACt, PRC (PRC calls them context scenes), Boardmaker SDP, low tech VSD devices by Enabling Devices and on the Boardmaker Activity Pad) are offering VSD on their devices, some companies are even offering them to the exclusion of traditional grids of symbols or photos or they are making it very, very difficult to use traditional grids of symbols photos within their software (hours of reprogramming VSDs to grids - this is true on InterAACt on the emerging communicator level).

However many of those involved with the decision when choosing AAC hardware and software do not have any idea what research has been done on VSDs and whether or not they would be beneficial to the individual who will be using the AAC device. Then the device arrives and suddenly there is this huge demand to learn how to use VSDs or reprogram to avoid the VSDs.

The research on VSDs seems to be primarily done on older (elderly) AAC users who have aphasia and secondarily done on those with autism spectrum disorders. There is some theroretical writing about VSDs and young children, but not much research. There is little research on VSDs in other populations (cerebral palsy, brain injury, Down Syndrome, Fragile X, etc.), nor is there any research on VSDs when the access method is not some kind of direct selection (i.e. for those who use auto- or step-scanning). Where there is research, i.e. this study for small children, the sample size is small (n=5) or the research focuses on personally relevant VSDs (photos of a person's actual surroundings as opposed to abstract drawings). This leaves decision makers in a void of information and presents a challenge when working with individuals outside of the areas that have been researched (everyone except young children, those with ASD and those with aphasia).

There is an assumption that visual scene displays reduce cognitive load, but this likely varies by individual (i.e. some individuals may find VSDs easier, but others may find traditional grids with no questions as to what is selectable vs. what isn't easier. If you are a PC user think about whether or not you like to view folders in thumbnail, icon, list or another format. This varies from person to person and task to task. The need for VSD may also change based on the persons style of learning - highly visual people, like most people with ASD may prefer the VSDs while others may prefer traditional grids). There is also an assumption that visual scenes will act as a visual cue to prompt conversation, but while this is possible it is also possible that a VSD can act as a distractor and lead away from the point that needed to be made (think about how often we write in IEPs to decrease visual distraction as an accomodation).

In short we don't know what visual scenes mean to our students. We are left where we are often left when teaching those with low incidence multiple or severe disabilities: direct trials and data collection is the only way to determine what will work and what won't. That means in the current trend of VSDs it is even more important than previously to rent an AAC devices for an extended period of time and run trials of the different types of software (with VSDs like InterACCt software and without VSDs like Gateway software) before you order. Additionally it is imperative that trials be done on the most current software available because if the software has changed the ability to access it may also change.

Blink Twice is making a foray into this area with its Tangorama download for the Tango!You csn't use photos.The scene is laid out with six objects in it falling where the six Tango! buttons normally are.You remove the physical grid to use this function.You cannot create your own.They have a couple different themes. This is new, and it will be interesting to see where they go with it.Their trials are now free.

The following are some resources (actual research) on VSDs. I'm shocked that under your references for VSDs I don't see any of the big PSU names in AAC research. The claim is not that VSDs work for everyone but that they can be effective in working with beginning communicators. If you read the research on cognitive organization - that should explain the lessened cognitive demand issue. Grid systems are typically organized in a way that makes sense to adults who are already proficient communicators and are literate. Young children have been proven to learn and organize language differently than adults do. Young children learn language in the here and now and organize it by the context in which they learn it. Alphabetical or grammatical organization makes sense to adults because they are literate but these organizations may not be appropriate for young children. Most very young children organize language byt the context in which they learn it and subsequently encounter it. There are a number of other reasons why VSDs may be more favorable for language learning in early communicators - but you can see for yourself in the literature. The idea is not to use VSDs forever, but to use them to teach language more rapidly (for young children or beginning communicators) and then transition to more traditional grid systems. Clearly there are limitations to VSDs (more limited potential for novel messages, vocabulary size, etc.) and they may not be ideal for many people. Additionally, there seems to be some confusion about what constitutes a VSD. Photographs are preferred over the illustrations found in some programs, and they should involve real people interacting.

Here is a short list of some resources for those who wish to do their own research on VSDs (though there is plenty more):

Wilkinson, K. M., & Light, J. (in press). Observation of humans in naturalistic visual scenes: Implications for the design of symbols and displays for use in aided AAC interventions. Journal of Speech-Language-Hearing Research (Language).

Light, J., & Drager, K. (2007). AAC technologies for young children with complex communication needs: State of the science and future research directions. Augmentative and Alternative Communication, 23(3), 204-216.

Emily thank you for sharing your opinions. However I would like to point out that this blog post was written in September 2008. That is before some of the links you shared were written and before many of them became available to "lay people" like me. It is unfair of you to be so chastising of me for not citing research that had not yet been done! Even so it remains true that much of the research you cite is on young children, mostly typically developing. The one on scene processing and context was done on typical adults. This blog is aimed at teachers of school age children with moderate to severe intellectual disabilities. One cannot assume that research based on young children or typical adults will carry over to the population this blog is about. Also the idea of naturalistic scenes being preferred did not become common knowledge until well after this blog post was written and posted. And I continue to see in my daily practice with many, many children ages 5-21 with complex communication needs including intellectual disabilities that VSDs are confusing rather than illuminating. Although some vendors (Dynavox Compass) have added boxes around what is "clickable" in VSDs most have not and my students do not understand that touching different part of the VSD lead to different messages being played. In short for my learners VSDs are confusing. So while I appreciate the comment I wish you had thought more about the context of the blog post (the date, who the audience was) before being shocked and lecturing about young children and VSD (as this blog is not aimed at speech therapists working with young children).

As the parent of a child with significant communication and learning issues relating to his disabilities, I can attest to the fact that research is all well and good if you are working with a person who is likely to be less than 2 SDs from norms. This is the problem I have with educators and therapists who are so stringently married to the research; they seem unable to accept that there is no one size fits all answer.

VSDs do NOT work for my child at all. They are, for him, too cluttered and too distracting; He does not have the executive function skills which would allow him to rapidly process and infer that he can touch different places and get different words/messages. He would, most likely, need to explore the image independently for a while to, essentially, memorize the motor plan before he was able to then put it in context.

While I know the commenter did note that there are always exceptions, I find there is a tremendous disconnect between the "Research" (capitalization and quotes intentional) and those learners who are more like my son. Frankly, the reason there is not much data on kids like mine is precisely because they DON'T fit the norms and are undesirable as research subjects; one cannot tease out cause vs correlation so it skews the data.

Kate, as always, I find your insights and hands-on experience invaluable. I'm grateful for the years I have been reading your blog.

This conversation brings up some very important points about what research is and is not.

To me, research means having a real question and seeking to develop scientifically valid data that informs the answer.

Many lines of research in AAC are in the first stages of development, as compared to other comparable fields. In fact, you could argue that all lines of research in the AAC domain are still early stage.

That being said, I believe a good approach is to look at all the available evidence and support each other in our quest for knowledge. We are all in this together and all have the ability to collaborate to make a difference.

Both Kate's (2008) sharing and Emily's sharing of resources is good. Hopefully Emily you can laugh at the fact that you were shocked that Kate had not shared studies that were even a glimmer in the psu crew's eyes.

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